Republicans Want More Pregnant Women in Prisons. A New Book Describes What It’s Like.

“Birth Behind Bars,” by Rebecca Rodriguez Carey, provides rare insight into the experiences of pregnant women in prisons.Mother Jones illustration; Rebecca Rodriguez Carey

Women are the fastest-growing^[2] population of incarcerated people. And if Republicans get their way, more pregnant women will be joining their ranks.

That’s because conservatives are behind a growing push to criminalize pregnancy outcomes^[3] nationwide, in part by giving full rights to fetuses^[4]. And while abortion opponents have long claimed they do not want to criminalize abortion-seekers themselves^[5], since the Supreme Court’s 2022 overruling^[6] of Roe v. Wade, a growing number of conservative lawmakers have begun introducing^[7] bills that would treat abortion as homicide and criminalize abortion-seekers. These laws will likely put more Black women and Latinas, who are already imprisoned^[8] at higher rates than white women, behind bars.

President Donald Trump’s immigration crackdown^[9] is also ensnaring pregnant immigrant women: A report issued^[10] last month by the office of Sen. Jon Ossoff (D-Ga.) alleged that officials identified more than a dozen credible reports of the mistreatment of pregnant women in Immigration and Customs Enforcement custody, which included not receiving adequate, or even urgent, medical care and being denied food. The Department of Homeland Security has disputed^[11] those allegations, saying in part, “Detention of pregnant women is rare and has elevated oversight and review.”

These recent events make Rebecca Rodriguez Carey’s new book, Birth Behind Bars: The Carceral Control of Pregnant Women in Prisons^[12], incredibly timely. Based on in-depth interviews with nearly three dozen women who were incarcerated in prisons throughout the Midwest while pregnant, the book provides rare insight into the experiences of pregnant women behind bars—an issue that lacked^[13] federal data until the Bureau of Justice Statistics (BJS) issued^[14] its first report on the state of pregnant women in prisons earlier this year. But even the exact number of pregnant women in prisons remains unclear, in part because incarcerated women do not always have access to pregnancy tests: The BJS report, for example, cites^[15] more than 320 in state and federal custody in 2023, but past research from scholars and advocates has estimated^[16] about 3,000 pregnant people are admitted to US prisons annually. “This invisibility,” Rodrigeuz Carey told me, “really contributes to systemic neglect.”

In her book, Rodriguez Carey, an associate professor of sociology and criminology^[17] at Emporia State University in Kansas, counters this historic invisibility by relaying women’s experiences being pregnant, laboring, and giving birth while in prison. Some stories convey the despair and desperation you may expect: Some women recounted purposefully committing crimes in order to be pregnant in prison rather than on the streets; others recalled falling into postpartum depression after being separated from their babies after giving birth while incarcerated. But the book also spotlights the surprising ways women managed to cultivate hope, by hosting makeshift baby showers and making plans for how they would make their children proud once released.

I spoke with Rodriguez Carey via Zoom last month about the state of abortion access in prisons post-Roe, the persistent problem of shackling incarcerated people during childbirth, and what most surprised her during the course of her research.

This interview has been lightly condensed and edited. 

I was struck by the fact that some of the women you interviewed deliberately committed crimes in order to have their basic needs for food, shelter, and medical care met in prison during their pregnancies. What do these women’s experiences indicate about the state of pregnancy care in the US more broadly?

Well it’s really, really bad care when you have women who are seeking refuge in a carceral system. And that’s not to say that that the care in prison is optimal care by any means, but for those who are living at the margins of society, who are in extreme poverty and don’t know where their next meal is coming from, don’t know where they are staying each night, for them the mark of being a good mother is to ensure that those basic needs are met. And so that means turning to our criminal legal system. It’s really interesting to me that the incarcerated population are the only group of people in the US that are constitutionally guaranteed health care^[18]—that really says something. 

You have some prisons being more progressive with their efforts to provide wraparound services, but then you have other prisons where there’s not a lot of prenatal and postpartum care, and so there’s really just a wide variation of care there from state to state, and even from facility to facility. I think that speaks to the larger picture of inequalities in the US. There’s an absence of a social safety net, and we have people turning to the criminal legal system to ensure their basic needs are met.

Even before the Dobbs decision that revoked the constitutional right to abortion, accessing it in prison was difficult. Only two percent of participants in the BJS report had abortions; other research has found an even lower rate. What sort of barriers did incarcerated people face when Roe was still the law of the land?^[19][20]

Many states have laws^[21] that prohibit any sort of state funding to go toward abortion. That includes travel—so if an incarcerated woman is looking to access an abortion out of state, typically you have to have a correctional officer accompany that woman. That would require state funding, to be in a correctional van for transportation and to provide the salary for the accompanying correctional officer. Many women who are incarcerated may not know that they are even pregnant until they come to prison, if they are living on the streets, for example, and haven’t had access to routine health care in some time. And so by the time they learn of their pregnancy, it’s often too late, because many states have laws^[22] that regulate the number of weeks that an abortion can be performed.

Many pregnant women in custody remain shackled while laboring and giving birth despite the fact that leading medical groups have denounced this practice. What did your interviewees say this experience was like for them? ^[23][24][25]

They felt like they were caged animals. When you are in the state of giving birth, you are extremely vulnerable. You’re not necessarily at a risk of fleeing; there have been no documented cases^[26] to date of a woman trying to escape while in labor. Many of the women that I interviewed had cesarean sections, so they were on the operating table, numb from the waist down—you are not going anywhere at that moment.

Most women who are incarcerated are there on non-violent crimes^[27], and even if a woman is pregnant who committed a violent crime, she’s not necessarily posing a risk to society while you’re in that vulnerable state of childbirth, where your legs are in stirrups and you have a correctional officer often in the room. Many of these correctional officers are men, and a lot of the women I interviewed talked about how they had experienced sexual abuse growing up, so that adds just another layer of harm when you’re in this very vulnerable state, often in layers of undress or completely naked.

Most states have laws on the books now restricting shackling during delivery. But how widespread of a problem does this remain? ^[28]

It’s really hard to say. A state may have a policy, but then we know that the policy is often different from the reality of what takes place. Many states that have issued restrictions on shackling still leave it up to correctional officers if there is a point of threat or perceived harm. And I think when we look at the different layers here, of who is more likely to be considered harmful or posing a risk to society, that’s women of color. So you still have these tropes that are persisting behind bars.

What about prison nursery programs that allow mothers to parent their newborns in prison—what benefits do they offer and why aren’t they more common? [Editor’s note: There are currently 11 state-run prison nursery programs, plus two more operated by the federal Bureau of Prisons.]

The first prison nursery program has actually been in place since 1901, so this is not necessarily new. Women who go through a prison nursery program and have access to that oftentimes there are reduced^[29] recidivism^[30] rates, there’s improved^[31] maternal mental health^[32] and fetal health outcomes^[33]. Otherwise they’re meeting their children, and they’re saying goodbye all in a span of 24 hours, and so that’s going to have negative health implications for years to come. 

There are no national mandates or standardized policies governing the incarceration of pregnant women. As a result, it’s up to individual states—and even specific correctional facilities—to decide whether to invest in such programs. Unfortunately, awareness among policymakers remains limited. Prior to the 1900s, reformatories often emphasized family bonds, allowing incarcerated women to live with their newborns—much like today’s prison nursery programs. But by the 1970s, most states moved toward a more punitive approach, passing legislation that effectively eliminated many of these programs.

Some of your interviewees used their incarcerations during pregnancy as a “transformative period” and sought to “optimize pregnancy and birth outcomes” despite their circumstances. Can you say more about how they did so? 

Many of the women that I interviewed had been pregnant before. Some of them had also been incarcerated before, but this was the first time they were both pregnant and incarcerated. Many of them talked about how being pregnant and incarcerated was rock bottom, and that this was very much a wake up call to do right by their unborn child. Many of the women interviewed talked about how during previous pregnancies they were out on the streets, doing drugs, getting into trouble left and right. And so when they were in prison, it was really this time where they could focus on their pregnancy. So that was really special for them, and it was a time where they were doing their best to take advantage of different programs and initiatives that they maybe had access to in their prisons, like pregnancy support groups, for example, reading all the books and trying their best to implement that advice. The women talked about how when you’re incarcerated, all you have is time to think and make the best choices for your unborn child.

Is there anything that surprised you in doing this research?

I think one of the biggest takeaways from me was how much hope is found inside prisons, where you have women coming together, given the absence of maternal healthcare, given the absence of institutional resources and support, creating their own networks of community and care. Food was a huge topic; pregnant women in prison don’t have access all the time to regular and nutritious foods. So you have other women who are incarcerated helping them out and coming together and saying, “Hey, I don’t want my baked potato, you can have it because I know you’re pregnant and you need these calories.”

Women are also taking pregnant women, especially the younger ones, under their wings, and saying, “be sure to get a job in the kitchen while you’re incarcerated, because that way you have regular access to food.” So you see these informal networks of support.

After a woman gives birth, she’s sent back to prison, often within 24 to 48 hours of giving birth and asked to fall back in line as if nothing has happened, even though her world has just been rocked. So you have women who are incarcerated really coming together and rallying around the pregnant women to provide that support and care.

What gives you hope for pregnant people in prisons and their newborns? 

The Kansas Children’s Discovery Center in Topeka has a program called^[34] Play Free, which allows incarcerated mothers and grandmothers to spend a day at the children’s museum playing with their kiddo, free of these cages and environments that are not child- and family-friendly at all. It’s been really great to see the transformation, where it started just as a partnership with the Topeka Correctional Facility, and has since expanded to the men’s facilities in Kansas. You have incarcerated fathers as well, and centering the children in all of this is important.